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The women’s movement gave us the truism that the personal is political, and nowhere is the tension between private life and public policy more acute than in the realm of sex and procreation. In her previous books, historian Elaine Tyler May probed baby boom family life and the status of childlessness in a country obsessed with reproduction. Now she’s taking on the history of the birth control pill, which turns 50 this year. An invention spawned amid lofty policy goals (early advocates hoped to eradicate worldwide poverty) and often credited or blamed for sparking the sexual revolution, the pill perhaps surprisingly has had its greatest impact on the lives of married women, according to May.

“America and the Pill’’ is no sweeping historical narrative but rather a sober assessment of a medication that didn’t live up to its hype but still became, May writes, “central to some of the most profound developments in both public and private life over the last half century.’’ Through research into the medical, social, and political conflicts surrounding the pill, as well as the voices of women contacted through an Internet survey, May charts the progress of this most personal and political innovation.

Women have always sought to avoid unwanted pregnancies, of course; condoms emerged by the Middle Ages, and pessaries, herbal potions, and withdrawal have been with us even longer. But May reminds us that an inexpensive, reliable contraceptive was a revolutionary dream in the decades leading up to the pill’s commercial arrival. “Science,’’ in the words of Margaret Sanger, activist and Planned Parenthood founder, “must make woman the owner, the mistress of herself,’’ through allowing her the choice of whether or when to have a child. Sanger, who grew up one of 11 children in a working-class, Irish Catholic family, saw a future in which poor women would “use direct action by refusing to supply the market with children to be exploited, by refusing to populate the earth with slaves.’’

Sadly, May points out, Sanger’s activism on behalf of gender and economic equality was overshadowed by her collusion in the 1920s with those who sought population control for reasons of racial purity. By the ’50s, on the verge of the pill’s debut in the marketplace, Sanger sounded more hateful than heroic, writing of the need for contraceptives in “slums, jungles, and among the most ignorant people,’’ and advocating “national sterilization for certain dysgenic types of our population.’’ The bigotry that mars her later writings has obscured the value of her earlier work, leaving a muddled legacy. I wish May had gone deeper into the story of Sanger’s reactionary evolution; to write that “Sanger compromised her initial radical socialist principles’’ in order to achieve her birth control goals feels inadequate or even defensive.

May traces the pill’s development through laboratories devoted to solving the problem of infertility: an irony that makes sense when you remember that in both assisted reproduction and contraception the scientific task is to nudge the roulette wheel of human procreation.

Once women gained the means to control their own fertility, is it any surprise that religious, social, and political forces moved in to exert their own control? As development of the birth control pill played out in the public eye, newspapers and magazines wondered whether the pill would solve overpopulation, enable women to become effortlessly promiscuous, or both (the answer, it turned out, was neither, really).

The pill never took hold among the populations whose growth was perceived as problematic by mid-century scientists — that is, poor people in the developing world — and was slow to be embraced by those whose fertility upset the eugenicists. As May points out, black women in particular had good reason to mistrust anybody trying to control their childbearing; for decades after the pill’s release, many were torn between “desire for access to contraception and suspicions of the motives of birth controllers.’’

But while women and their families felt reasonable ambivalence at the pill’s promise and risks, negative reactions from other quarters revealed a simple fear of women’s sexual agency. Birth control provided a perfect battleground for social changes already afoot in American post-war society, especially the fight for women’s equality and the toppling of monolithic authority figures — chief among these was the Catholic Church, whose own tortured history with the pill is one of the book’s most fascinating sections. Many will be shocked to learn how close the Vatican came to accepting the pill in the early 1960s. In the end, of course, Pope Paul VI sided with the minority of his advisory council (60 of 64 theologians had proposed ending the ban) and affirmed the church’s continued opposition to any form of contraception (save for the rhythm method, which they only approved in 1951). The move, May writes, “weakened the power of the papacy in the lives of Catholics, and . . . turned many Catholics away from the Church altogether.’’

It’s difficult to calibrate just how influential the pill has been, and May is careful not to overstate. The pill didn’t end worldwide poverty or create the sexual revolution (though it did coincide with the end of the high teenage marriage rates seen in the 1950s — in 1959, the year before the pill debuted, nearly half of American brides were under 19). Still, May writes, the pill profoundly benefited married women, who were now able to expand the time between wedding and babies, filling it with educational and occupational opportunities previously unavailable to them. It’s in such small but seismic shifts, this slender but important book reminds us, that history is made.